Substance Abuse Therapy : Ambulatory Care Settings

behavioral therapies, to provide a whole-patient approach to the treatment of opioid use disorders" (p. 2). There are two types of medications commonly used in opioid use disorder MAT; Naltrexone and Buprenorphine. "Naltrexone is

Centers for Disease Control and Prevention (CDC) reported that there are about 100,000 of deaths per year and there are approximately 8 million people in United States who have substance abuse problem (CDC, 2015). A better understanding and greater attention to the commonly abused substance and its treatment would be beneficial in a providers practice and will also protect the provider from the legalities of prescribing these medications. There are several forms of treatment for every abused substance and the main goal is to help the patient to stop the stop and helping them during the phase of withdrawal. The intent of this paper is to discuss the commonly use substance for abuse

Methadone is one of the most common medications used to treat opioid addiction. It decreases the symptoms of opioid withdrawal and inhibits the euphoric effects caused by abusing heroin and prescription opioids such as oxycodone. When used as prescribed and under the supervision of a trained physician, methadone is an effective complement to treatment. SAMHSA also recommends patients remain on methadone treatment for at least 12 months. Many people require multiple years of treatment. When discontinuing methadone treatment, patients should slowly taper off of it under doctor supervision. Buprenorphine decreases the potential for opioid abuse, reduces withdrawal symptoms and cravings and decreases the risks of overdose. Because buprenorphine

Objective: This study compared the effectiveness of methadone, Subutex, and Suboxone in reducing illicit drug use during treatment for opioid dependency and retaining patients for the duration of treatment.

Physical dependence to a substance is a state of adaptation that is manifested by specific signs and symptoms of certain drugs that can be produced as a result of abrupt cessation, rapid dose reduction, decreasing blood level of the drug, or administering an antagonist. Dependence is a normal physiologic consequence of extended opioid use, and by itself, is not the same as addiction.¹ To treat this state of reliance, opioid agonists, such as methadone and buprenorphine-based regimens, have been the mainstays of therapy. While they are both long-acting and bind to opioid receptors in the central nervous system, they differ in their mechanism of action and how they are perceived by the general population. This consult’s objective is to evaluate current literature that is available regarding the differences in outcomes and efficacy between methadone and buprenorphine-based treatment in opioid-dependent patients.

Opioid dependence in the United States is increasing in numbers with those addicted to heroin and prescription opioid analgesics. Opioid use includes morphine, codine, oxycodine, the painkillers oxycodone, hydrocodone, fentanyl, and heroin. Several different treatment options are available for opioid dependence. Behavioral therapy includes counseling, cognitive therapy, phychotherapy, and the twelve step recovery program developed by Alcoholics Anonymous. Prescriptions can also be used for the treatment of opioid dependence. For example, methodone is used to help treat heroin abusers, and buprenorphine is used to treat opioid dependence, more specifically, Suboxone.

The pharmacological treatments are methadone buprenorphine (subutex) , buprenorphine and naloxone (suboxone), naltrexone. There are also many opioid reversal agents used to reverse the effects of opioid intoxication such as naloxone (narcan) given as iv/im/sc by healthcare providers. It is also available as an autoinjector im/sc to be used at home by families. The behavioral therapies used to stop an opioid addiction are Cognitive Behavioral Therapy, Motivational Incentives, Motivational Interviewing and Group Therapy. These therapies might include addressing a patient’s motivation to change their ways, provide them incentives to stop taking drugs, help them build a resistance to drug use, replace their drug using activities with constructive and rewarding activities, help them improve their problem solving skills and help them build better personal relationships. The best way to help an addict is to educate them. The education has to follow certain criteria such as let the patient know that they will not be able to use the substances in a controlled fashion, The treatment alone is hardly ever successful so they need to go to rehabilitation to get a full recovery. Their own willpower will not help them and that they need to go to Narcotics Anonymous, that recovery is possible and many have succeeded, that after a relapse they can still stop the

For those who suffer from substance abuse, there are often groups and programs created to help maintain sobriety, learn life lessons, relapse avoidance, and NA/AA groups, geared to work with both the mental illness as well as the addiction. In these clinics and facilities, there are often medication evaluations and consultations available, to monitor and help maintain medication adherence, and broaden understanding of the particular medications taken by patients. This

Treating substance abuse can include multiple interventions. Common treatments include counseling in a group or individual, inpatient facilities, and medications. Since Alexia scored high on her ASI and CSSA she will be partaking in these treatments while attending an inpatient facility. Alexia will be undergoing Cognitive Behavioral Therapy (CBT) while in treatment. It has been supported in many trails as a treatment for substance abuse. CBT will cause Alexia to focus on the immediate problem and work on the goals set (Brewer et al, 2009). She will be experiencing CBT during individual counseling and group sessions.

In 1948, a drug that produces a harmful reaction when mixed with alcohol, known as disulfiram, was introduced to treat alcoholism. As a result of the negative reaction, alcoholics are discouraged from consuming alcohol during treatment. However, the drug has proven to be ineffective unless combined with psychotherapy and the patient’s motivation. Furthermore, many doctors fear that the use of disulfiram may cause a patient to develop a dependency on it rather than on alcohol. Therefore, Dr. Sober is interested in designing a treatment that is effective by combining it with various treatments to avoid the disadvantages. Dr. Sober’s treatment involves subjects who have volunteered to participate in the study because of their inability to afford

Physicians have several options for treating alcohol use disorders. Behavioral therapy can help alcoholics recognize and avoid high-risk situations, and referral to programs that provide peer support, such as Alcoholics Anonymous, can increase a person’s chance of recovery. Therapists can also prescribe medications that decrease the appeal of alcohol. Studies show disulfiram, acamprosate and naltrexone help most people abstain from alcohol. Disulfiram causes unpleasant side effects such as sweating, nausea, headache, vomiting and chest pain when patients consume alcohol. The severity of the effects differs among patients, and is correlated with the amount of alcohol consumed. Naltrexone inhibits euphoric effects or feelings of intoxication

include two nicotine patches, nicotine gum and nicotine lozenges. In addition to over the counter products, a smoker wanting to quit smoking may obtain nicotine nasal spray, inhaler (Zyban) and the recently approved nicotine-free tablet (CHANTIX) by prescription.5,12,13 CHANTIX

Nicotine replacement therapy (nicotine patches, gum, lozenges and inhalers) increases quit rate in any setting by 50-70% (Stead et al, cited in Ivers 2011)

The second step that a smoker can take to quit is to use replacements for nicotine. Replacements can include gum, nicotine patches, sprays, just to name a few. These work by “giving you nicotine without the use of tobacco.” ("Nicotine Replacement Therapy for Quitting Tobacco" 2017) This is called Nicotine replacement therapy (NRT). This type of therapy helps “relieve some of the physical symptoms so that you can focus on the psychological (emotional) aspects of quitting.” ("Nicotine Replacement Therapy for Quitting Tobacco" 2017) This along with therapy can increase your chances of

would like to discuss replacement therapy for tobacco, and the helpful ways of quitting, there are different ways to quit smoking and kicking that nasty habit, to increase your life term. According to the CDC Tobacco use can lead to tobacco/nicotine dependence and serious health problems. Quitting smoking greatly reduces the risk of developing smoking-related diseases and early death. It can lead to lung cancer and many other types of cancer and risk for heart disease, stroke, and peripheral vascular disease (narrowing of the blood vessels outside your heart). (, 2015) There have been different types of therapy to reduce the use of nicotine and tobacco use. Such as medications that’s been approved by your PCP, nicotine patches, and Hypnosis.